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. 2011 May 4;6(5):e18574.
doi: 10.1371/journal.pone.0018574.

Detrimental effects of environmental tobacco smoke in relation to asthma severity

Suzy A A Comhair  1 , Benjamin M Gaston, Kristin S Ricci, Jeffrey Hammel, Raed A Dweik, W Gerald Teague, Deborah Meyers, Elizabeth J Ampleford, Eugene R Bleecker, William W Busse, William J Calhoun, Mario Castro, Kian Fan Chung, Douglas Curran-Everett, Elliot Israel, W Nizar Jarjour, Wendy Moore, Stephen P Peters, Sally Wenzel, Stanley L Hazen, Serpil C Erzurum; National Heart Lung Blood Institute Severe Asthma Research Program
Collaborators, Affiliations

Detrimental effects of environmental tobacco smoke in relation to asthma severity

Suzy A A Comhair et al. PLoS One. .

Abstract

Background: Environmental tobacco smoke (ETS) has adverse effects on the health of asthmatics, however the harmful consequences of ETS in relation to asthma severity are unknown.

Methods: In a multicenter study of severe asthma, we assessed the impact of ETS exposure on morbidity, health care utilization and lung functions; and activity of systemic superoxide dismutase (SOD), a potential oxidative target of ETS that is negatively associated with asthma severity.

Findings: From 2002-2006, 654 asthmatics (non-severe 366, severe 288) were enrolled, among whom 109 non-severe and 67 severe asthmatics were routinely exposed to ETS as ascertained by history and validated by urine cotinine levels. ETS-exposure was associated with lower quality of life scores; greater rescue inhaler use; lower lung function; greater bronchodilator responsiveness; and greater risk for emergency room visits, hospitalization and intensive care unit admission. ETS-exposure was associated with lower levels of serum SOD activity, particularly in asthmatic women of African heritage.

Interpretation: ETS-exposure of asthmatic individuals is associated with worse lung function, higher acuity of exacerbations, more health care utilization, and greater bronchial hyperreactivity. The association of diminished systemic SOD activity to ETS exposure provides for the first time a specific oxidant mechanism by which ETS may adversely affect patients with asthma.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Analysis of total SOD activity in all asthmatics exposed to ETS or non-ETS.
Asthmatic subjects exposed to ETS have significantly lower SOD activity (p = 0.04).
Figure 2
Figure 2. Model-estimated environmental tobacco smoke (ETS) effects on superoxide dismutase (SOD) activity.
ETS exposure was associated with the lowest SOD activity for females of African heritage, which was in greatest contrast to the result for males of non-African heritage. The graph shows 95% confidence intervals for SOD activity by Gender/Race combinations.
See this image and copyright information in PMC

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References

    1. Jarjour NN, Busse WW, Calhoun WJ. Enhanced production of oxygen radicals in nocturnal asthma. Am Rev Respir Dis. 1992;146:905–911. - PubMed
    1. Gaston B, Drazen JM, Loscalzo J, Stamler JS. The biology of nitrogen oxides in the airways. Am J Respir Crit Care Med. 1994;149:538–551. - PubMed
    1. MacPherson JC, Comhair SA, Erzurum SC, Klein DF, Lipscomb MF, et al. Eosinophils are a major source of nitric oxide-derived oxidants in severe asthma: characterization of pathways available to eosinophils for generating reactive nitrogen species. J Immunol. 2001;166:5763–5772. - PubMed
    1. Wu W, Samoszuk MK, Comhair SA, Thomassen MJ, Farver CF, et al. Eosinophils generate brominating oxidants in allergen-induced asthma. J Clin Invest. 2000;105:1455–1463. - PMC - PubMed
    1. Dweik RA, Comhair SA, Gaston B, Thunnissen FB, Farver C, et al. NO chemical events in the human airway during the immediate and late antigen-induced asthmatic response. Proc Natl Acad Sci U S A. 2001;98:2622–2627. - PMC - PubMed

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